Author: Farhad Huseynov, Bursa Uludag University (6th year)
I am a 6th year medical student in Turkey and in my third year, I got interested in psychiatry, especially in the research field of psychiatry. But until that time I had never looked up any articles in PubMed or even in Google. I had heard a lot about ‘‘depression’’, ‘‘anxiety’’, ‘‘stigmatization’’ (experiencing them) but hadn’t thought that researching these terms could be life-changing…
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Dr. Link and Phelan (2001) develop a widely used conceptualization of stigma. Their conceptualization defines stigma as the convergence of some interrelated components:
In the first component, people distinguish and label human differences. In the second, dominant cultural beliefs link labeled persons to undesirable characteristics – to negative stereotypes. In the third, labeled persons are placed in distinct categories so as to accomplish some degree of separation of “us” from “them.” In the fourth, labeled persons experience status loss and discrimination that lead to unequal outcomes. Stigmatization is entirely contingent on access to social, economic, and political power that allows the identification of differentness, the construction of stereotypes, the separation of labeled persons into distinct categories, and the full execution of disapproval, rejection, exclusion, and discrimination.
After the publication of stigma literature, Dr. Meyer (2003) put forward the minority stress theory, which means “excess stress that individuals from stigmatized social categories are exposed as a result of their social, often a minority, position”. Researchers defined these stressors as unique, chronic, and socially based (1).
Unfortunately, LGBT individuals are exposed to both of these two concepts intensely. Health disparities observed in LGBT populations do not reflect psychological issues inherent to LGBT individuals but rather are the result of persistent stigma directed toward them. Fear of coming out, rejection sensitivity, concealment, and discrimination elevate the risk of depression, post-traumatic stress disorder, substance use, and self-destructive and suicidal behaviors among LGBT individuals). I want to give a simple statistic for understanding the situation better. LGBT youth make up 40% of all young people experiencing homelessness (only 3.8% of Americans identify themselves as gay, lesbian, bisexual or transgender). Therefore, they are more likely to face physical or sexual abuse, sexually transmitted diseases, and mental health issues.
We can still add other negative effects of stigma on LGBT health, but there are some interventions aimed at reducing stigma’s health impacts among this population. A recent study showed that structural interventions in school policies and practices may protect sexual minority youth against the risk of suicide. There is also another study that tested the efficacy of cognitive behavioral therapy for helping gay and bisexual men. This intervention resulted in significant reductions in depression, alcohol use, and HIV (human immunodeficiency virus) risk behavior (2).
Why am I writing about this topic? There are several reasons, but the main one is that…. I am gay (I was in the closet, but this is my first declaration of my sexual orientation publicly) and I experienced (and I am still experiencing) stigma and minority stress first-hand. It was too tough when I didn’t have enough knowledge about what was going on. However, after research, my view on these issues improved and I tried to avoid the effects of stigma and minority stress. By writing this article, I want to increase the awareness of this health issue reach out to LGBT individuals who also suffer from stigma, and make them know that they are not alone.
References:
1- Hatzenbuehler, M. L., & Pachankis, J. E. (2016). Stigma and Minority Stress as Social Determinants of Health Among Lesbian, Gay, Bisexual, and Transgender Youth: Research Evidence and Clinical Implications. Pediatric clinics of North America, 63(6), 985–997.
2- Hafeez, H., Zeshan, M., Tahir, M. A., Jahan, N., & Naveed, S. (2017). Health Care Disparities Among Lesbian, Gay, Bisexual, and Transgender Youth: A Literature Review. Cureus, 9(4), e1184.